Medicine event forms: raising a professionalism concern

Please use this form to raise any concerns you may have about a UCLan medicine student’s professionalism. This includes MBBS, MPAS and MPAP students.

All forms go to the Professionalism Team within the School for review, triage and further action as necessary. When concerns have been raised, students are encouraged to reflect on their conduct and the circumstances of the incident(s). Lower-level concerns will generate a professionalism development opportunity (PDO).

Examples of a PDO include:

More serious concerns will raise a professionalism lapse. In this case, students are required to submit a written reflection and will also be required to meet with senior staff. Any further action will depend on the nature and gravity of the circumstances.

Examples of a professionalism lapse include:

Only staff and educators can complete a form to raise concerns about a student’s professional conduct. A student who wishes to raise concerns should approach their Academic Advisor or the Lead for Professionalism.

Guidance for completing forms:

Please complete one form per student
Give as much relevant detail as possible
Remember to consider the student’s confidentiality e.g. regarding their health or personal issues
Please inform the student that you are raising concerns as soon as possible, either face to face or via email/phone
Remember that the information on the form will be sent verbatim to the student. You may submit the form anonymously, however the student will often know who has raised the concerns and submitted the form
Please issue the lapse within 48 hours of the concern being raised
Please report factual and objective rather than subjective evidence, opinion or hearsay

For further guidance on the professionalism standards expected by the General Medical Council (GMC), please follow these links:

If you have any further questions, would like to amend your form after sending it or withdraw altogether, please email us to discuss.